"Five years ago, Tal Iram, a young
neuroscientist at Stanford University, approached her supervisor with a daring
proposal: She wanted to extract fluid from the brain cavities of young mice and
to infuse it into the brains of older mice, testing whether the transfers could
rejuvenate the aging rodents.
Her supervisor, Tony Wyss-Coray,
famously had shown that giving old animals blood from
younger ones could counteract and even reverse some of the effects
of aging. But the idea of testing that principle with cerebrospinal fluid, the
hard-to-reach liquid that bathes the brain and spinal cord, struck him as such
a daunting technical feat that trying it bordered on foolhardy.
“When we discussed this initially, I
said, ‘This is so difficult that I’m not sure this is going to work,’” Dr.
Wyss-Coray said.
Dr. Iram persevered, working for a
year just to figure out how to collect the colorless liquid from mice. On
Wednesday, she reported the tantalizing results in the journal Nature:
A week of infusions of young cerebrospinal fluid improved
the memories of older mice.
The finding was the latest
indication that making brains resistant to the unrelenting changes of older age
might depend less on interfering with specific disease processes and more on
trying to restore the brain’s environment to something closer to its youthful
state.
“It highlights this notion that
cerebrospinal fluid could be used as a medium to manipulate the brain,” Dr.
Iram said.
Turning that insight into a
treatment for humans, though, is a more formidable challenge, the authors of
the study said. The earlier studies about how young blood can reverse some
signs of aging have led to recent clinical trials in which blood donations from
younger people were filtered and given to patients with Alzheimer’s or
Parkinson’s disease.
But exactly how successful those
treatments might be, much less how widely they can be used, remains unclear,
scientists said. And the difficulties of working with cerebrospinal fluid are
steeper than those involved with blood. Infusing the fluid of a young human
into an older patient is probably not possible; extracting the liquid generally
requires a spinal tap, and scientists say that there are ethical questions
about how to collect enough cerebrospinal fluid for infusions.
While there are theoretically other
ways of achieving similar benefits — such as delivering a critical protein in
the fluid that the researchers identified or making a small molecule that
mimics that protein — those approaches face their own challenges.
Jeffery Haines, a biochemist who has
studied cerebrospinal fluid
and multiple sclerosis at Mount Sinai Medical Center in New York,
said that the study had elegantly identified how certain ingredients in the
fluid might promote memory. But he said the general public’s appetite for
anti-aging drugs was outpacing the science.
“In general, people are looking for
the Holy Grail of aging, and they think there is going to be a magical factor
that’s being secreted that’s just going to reverse this thing,” he said. “I
don’t think it’s that simple.”
Cerebrospinal fluid made for a logical target for
researchers interested in aging. It nourishes brain cells, and its composition
changes with age. Unlike blood, the fluid sits close to the brain.
But for years, scientists saw the
fluid largely as a way of recording changes associated with aging, rather than
countering its effects. Tests of cerebrospinal fluid, for example, have helped
to identify levels of abnormal proteins
in patients with significant memory loss who went on to develop Alzheimer’s
disease. Scientists knew that there were also health-promoting proteins in
cerebrospinal fluid, but identifying their locations and precise effects seemed
out of reach.
For one thing, scientists said, it was difficult to track
changes in the fluid, which the body continuously replenished.
And collecting it from mice while
avoiding contaminating the fluid with even trace amounts of their blood was
extremely challenging.
“The field has lagged decades behind
other areas of neuroscience,” said Maria Lehtinen, who studies cerebrospinal
fluid at Boston Children’s Hospital and is the co-author of a commentary in
Nature about the new mouse study. “Largely this is because of the technical
limitations in studying a fluid that’s deep inside the brain, and that turns
over continuously.”
Dr. Iram was undaunted. She set about taking the liquid from
10-week-old mice, cutting above their necks and drawing out fluid from a tiny
cavity near the back of the brain while trying not to puncture any blood
vessels or poke the brain itself.
When she was successful, Dr. Iram said, the result was about
10 microliters of cerebrospinal fluid — roughly one-fifth of the size of a drop
of water. To collect enough for infusions, she had to do the procedure on many
hundreds of mice, taming the technical challenges that Dr. Wyss-Coray had
warned of by sheer force of repetition.
“I like doing these types of studies
that require a lot of perseverance,” Dr. Iram said. “I just set on a goal, and
I don’t stop.”
To infuse the young cerebrospinal fluid into old mice, Dr.
Iram drilled a tiny hole in their skulls and implanted a pump below the skin on
their upper backs. For comparison, a separate group of old mice was infused
with artificial cerebrospinal fluid.
A few weeks later, the mice were exposed to cues — a tone
and a flashing light — that they had earlier learned to associate with shocks
to their feet. The animals that had received the young cerebrospinal fluid
infusion tended to freeze for longer, suggesting that they had preserved
stronger memories of the original foot shocks.
“This is a very cool study that
looks scientifically solid to me,” said Matt Kaeberlein, a biologist who
studies aging at the University of Washington and was not involved in the
research. “This adds to the growing body of evidence that it’s possible,
perhaps surprisingly easy, to restore function in aged tissues by targeting the
mechanisms of biological aging.”
Dr. Iram tried to determine how the young cerebrospinal
fluid was helping to preserve memory by analyzing the hippocampus, a portion of
the brain dedicated to memory formation and storage. Treating the old mice with
the fluid, she found, had a strong effect on cells that act as precursors to
oligodendrocytes, which produce layers of fat known as myelin that insulate
nerve fibers and ensure strong signal connections between neurons.
The authors of the study homed in on a particular protein in
the young cerebrospinal fluid that appeared involved in setting off the chain
of events that led to stronger nerve insulation. Known as fibroblast growth
factor 17, or FGF17, the protein could be infused into older cerebrospinal
fluid and could partially replicate the effects of young fluid, the study
found.
Even more strikingly, blocking the protein in young mice
appeared to impair their brain function, offering stronger evidence that FGF17
affects cognition and changes with age.
The study strengthened the case that breakdowns in myelin
formation were related to age-associated memory loss. That is something of a
departure from the longstanding focus on the fatty insulation in the context of
diseases like multiple sclerosis.
Some scientists said that knowing
one of the proteins responsible for the effects of young spinal fluid could
open the door to potential treatments based on that protein. At the same time,
recent technological advances have brought scientists closer to observing
changes in cerebrospinal fluid in real time, helping them “peel back the layers
of complexity and mystery surrounding this fluid,” Dr. Lehtinen said.
Still, scientists cautioned that
those treatments would not materialize anytime soon. Among the difficulties are
understanding what other proteins might be involved and figuring out how to
harness their effects without causing separate problems.
But Dr. Wyss-Coray said that the
study filled a critical gap in the understanding of how the brain’s environment
changes as people age.
“The question is, ‘How can you maintain cognitive health
until you die?
How can you make the brain resilient
to this relentless degeneration of the body?’” he said, “and what a growing
number of studies show is that as we learn more about the aging process itself,
maybe we can slow down aspects of aging and maintain tissue integrity or even
rejuvenate tissues.””
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